Integrity & Compliance Program Manager

About the role

Summary: Accountable for leading, guiding, and directing the Trinity Health ministry or enterprise functional responsibilities. Enable ministry-level or enterprise-wide functional strategy to address internal or external business & regulatory issues; provide functional expertise and ensure fulfillment of performance and service standards. Responsible for consistent operating performance and achieving financial goals.

Responsibilities

• Collaborates with System Services Areas, Regions, and Health Ministries to ensure consistency and integration of strategy and operations.
• Maintains awareness of new industry developments and standards.
• Provides decision support, operations &/or optimization leadership focus.
• Assist the Integrity and Compliance Director with guiding and managing the compliance activities and initiatives for assigned ministry(ies).
• Provides advice, guidance and program management to ministry leaders in developing, implementing and attaining program goals while ensuring alignment to compliance strategies.
• Conducts investigations for local ministry and provides recommended action in response to outcome of investigation.
• Participates in Service Area and Enterprise Integrity and Compliance projects with a focus on standardization and process improvements.
• Support the Integrity and Compliance Director in developing, executing, and overseeing compliance initiatives within the ministry.
• Provide expert advice and strategic guidance to ministry leaders on program goals and compliance strategies.
• Lead and conduct internal investigations related to compliance concerns, ensuring thorough, timely, and objective outcomes.
• Deliver well-documented recommendations for corrective actions based on investigative findings.
• Partner with leaders across local ministries and enterprise functions to implement and sustain compliance strategies.
• Actively participate in Service Area and Enterprise-level compliance projects, focusing on process improvement and standardization.
• Collaborate on the development and rollout of organization-wide policies, training, and communication tools to foster a culture of ethics and compliance.
• Monitor emerging risk areas and regulatory changes, ensuring proactive and appropriate organizational response.
• Contribute to audit readiness activities and help strengthen internal controls across the ministry.
• Track compliance performance metrics and support continuous improvement initiatives to enhance overall program effectiveness.

Requirements

• Bachelor’s level degree in business, health administration, or a related field, a law degree, or an equivalent combination of education & experience.
• Minimum of five 5 years of relevant experience with increasing levels of responsibility in health care compliance &/or consulting including regulatory compliance, program metrics, performance assessment, & reporting outcomes, etc.
• Must possess a thorough understanding and knowledge of health care legal and regulatory practices, financial and internal control systems/procedures.
• Previous project, program, supervisory or management experience.

Qualifications

• Nice to have: Experience within a health care organization (including ambulatory and hospital settings) or equivalent work experience involving clinical documentation and coding reviews and working knowledge of Conditions of Payment including government and third-party payer regulations.
• Comprehensive understanding of Medicare Physician Fee Schedule and Medicare Claims Processing Manual for professional services.
• Comprehensive understanding of Conditions of Participation and Accreditation Standards.
• CHC, CHPC, CHRC, CCEP or equivalent certification.
• Leverage Lean/Six Sigma training and/or certification.

Skills

• Strong leadership and decision-making skills.
• Excellent communication and interpersonal skills.
• Ability to manage multiple projects simultaneously.
• Knowledge of health care compliance and regulatory standards.
• Experience in conducting investigations and providing recommendations.
• Proficiency in using Microsoft Office Suite and other relevant software.

Benefits

Not specified.

Pay

$47.23 - $70.85 hourly

Schedule

Not specified.